Anal Bleeding: When Is It from Hemorrhoids and When Is It a Cause for Alarm?

Introduction

The sight of blood after a trip to the bathroom can be alarming for anyone. However, not all bleeding is linked to a serious condition, and at the same time, not all minor bleeding can be ignored. The most important question is: when is anal bleeding just a symptom of simple hemorrhoids or a fissure? And when should you act quickly and see a doctor?

In this article, we'll identify the signs that distinguish minor bleeding associated with common anal conditions like hemorrhoids and anal fissures. We'll also cover when the alarm bells should ring—with practical steps you can take at home and a clear map of the stages of the condition, from mild symptoms to the modern interventional solutions available at Hemocure.

Important warning: Any anal bleeding deserves a medical evaluation if it lasts for more than two or three days or if it is recurrent. If it is accompanied by dizziness, palpitations, or a change in stool color to black/tarry (melena), you must go to the emergency room immediately.

First: When Is the Bleeding Likely from Hemorrhoids?

Hemorrhoids are swollen veins in the anal canal, often appearing with constipation, straining during bowel movements, or prolonged sitting. The signs that suggest the blood is caused by hemorrhoids are:

The blood is bright red and appears on toilet paper or as streaks on the surface of the stool.
You may experience itching/discomfort or slight swelling around the anus, and sometimes an external protrusion after a bowel movement.
The pain—if present—is more of an uncomfortable ache than a sharp, stabbing sensation.

If these symptoms sound familiar, you can read more about them here:

Learn About Hemorrhoids and Their Treatments (Arabic)
External Hemorrhoids: Symptoms and Appearance (Arabic)
Medicines for Hemorrhoids – For Initial Relief (Arabic)

Second: When Is the Bleeding from an Anal Fissure?

An anal fissure is a small tear or cut in the lining of the anus, often occurring after passing a hard stool. Its main distinguishing feature is:

Very sharp, stabbing pain during a bowel movement, which may last for hours afterward as a burning sensation.
Bright red blood on toilet paper or the surface of the stool.
Sometimes accompanied by a spasm of the sphincter muscle.

If you describe the pain this way, check out these articles:

And if you're confused about the difference, see:

Hemorrhoids or Anal Fissure: How to Tell the Difference? (Arabic)

Symptoms That Should Sound an Alarm

You should seek immediate medical attention if you experience any of the following:

Dark/maroon blood or black, tarry stool (melena) → This may indicate bleeding higher up in the digestive tract.
Heavy bleeding, blood clots, dizziness, or a rapid heart rate.
Recurrent bleeding for more than two to three days, or bleeding accompanied by unexplained weight loss or a persistent change in bowel habits.
If you are over 45 years old with recurrent bleeding or a family history of colon diseases, a colonoscopy is recommended.

Quick and Safe Steps for Minor, One-Time Bleeding

If the bleeding is minor and has occurred only once or twice, you can take these steps:

Increase Fiber and Fluids: Aim for 25-30 grams of fiber per day and drink plenty of water.
Warm Water Baths (Sitz baths): Sitting in a warm bath for 10-15 minutes after a bowel movement can help soothe the area.
Gentle Laxatives: Use as advised by a pharmacist.
Topical Ointments: Apply hemorrhoid/fissure creams for short periods.

For more information, see:

Medicines for Hemorrhoids (Arabic)
Treatment of External Hemorrhoids and Their Causes (Arabic)

Could the Bleeding Be Caused by Something Other Than Hemorrhoids or a Fissure?

Yes. Sometimes the cause can be inflammation, polyps, inflammatory bowel disease, or tumors. If there is a pus-like discharge or a small opening next to the anus, you should check for an anal fistula.

For more on anal fistulas, see:

Anal Fistula: Symptoms, Causes, and Treatment (Arabic)
What Is an Anal Fistula? And How Is It Treated? (Arabic)

How Is a Diagnosis Made at Hemocure?

The diagnosis is made based on:

Medical history.
Anal examination using a proctoscope.
Blood tests.
Colonoscopy in some cases.

Treatment Plan Based on the Stage of the Condition

Early Stage:
- Dietary modifications, warm baths, and ointments are recommended.
Intermediate Stage:
- Continued conservative treatment.
Advanced Stage:
- Laser hemorrhoid surgery or other interventional treatments.